Evaluation of enamel deproteinization in bond strength of orthodontic accessories: A split-mouth randomized clinical trial

Abstract

This split-mouth randomized clinical trial aimed to evaluate the influence of dental enamel deproteinization with sodium hypochlorite on orthodontic accessories breakages using 2 orthodontic adhesives. Forty patients with indications for orthodontic treatment with fixed appliances were randomly divided into 2 groups according to the orthodontic adhesive used: Transbond XT (3M Unitek, Monrovia, Calif) (n= 20) and Orthocem (FGM Dental Products, Joinville, Santa Catarina, Brazil) (n= 20). A split-mouth trial was conducted in the maxillary teeth; the deproteinization process with 5% sodium hypochlorite was performed on the experimental side. The opposite side served as a control without deproteinization. The primary outcome was the number of orthodontic accessories breakages. The randomization was performed using the BioStat software (AnalystSoft Inc, Walnut, Calif). Single-blind was applied for patients. Orthodontic accessories were bonded according to the manufacturer's instructions. The accessories breakages were followed during the first 6 months of treatment. Intergroup comparisons were performed with t tests and 1 and 2-way analysis of variance. Thirty-nine patients concluded the trial. The Transbond XT group comprised 20 patients (9 male, 11 female), with a mean age of 20.77 ± 6.44 years. The Orthocem group included 19 patients (9 male, 10 female), with a mean age of 23.14 ± 7.98 years. The application of sodium hypochlorite before bonding did not influence the number of orthodontic accessories breakages (P= 0.867). The type of adhesive used, associated or not with the deproteinization, did not affect the number of orthodontic accessories breakages (P= 0.929). Enamel deproteinization with 5% sodium hypochlorite did not impact the number of orthodontic accessories breakages. In addition, the 2 bonding adhesives used showed similar clinical results, with or without the enamel deproteinization. The trial was registered at ensaiosclinicos.gov.br, ReBEC (no. RBR-39ntmjk). The protocol was not published before trial commencement. This research did not receive any grant from funding agencies.